Hey Jon
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@jon-nyc How's everything going with the vaccine? Have you been tested for antibody response?
I was just talking with a friend and former colleague that had a double lung transplant two years ago. He was vaccinated a couple of months ago, but apparently the immunosuppressants he's on kept the vaccine from functioning well and he's still essentially unvaccinated... Apparently, it is pretty common.
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Yes - more or less. But there's some hope still.... I'll explain.
Johns Hopkins has a study going on about vaccine efficacy for solid organ transplant patients. They published in JAMA in March with preliminary data based on first shot only, and found that only 1 in 5 transplant patient mounted an antibody response after the first shot (checked on the eve of the second shot).
Further, they found that (as your friend alluded to), if you're on an antimetabolite (like cellcept, which I take) you are 5x more likely to NOT develop a response.
So yeah that's shitty news. But......
(a) it could be the case that we mount an antibody response, just later
(b) it could be that the second shot makes us develop one. Hopkins will probably release that data in the next month
(c) it could be that we never mount an antibody response but still develop a t-cell and b-cell response.So hope isn't lost.
As for me - on the eve of shot two I took an antibody test - NO FUCKING RESPONSE.
10 days before shot two, the Hopkins paper came out. Based on that, I asked my guy at Duke if he was ok with me dropping the cellcept for 3 weeks - one before shot two and two after - and he agreed. But, two weeks after shot two, when everybody is 'protected', I took another antibody test, and - NO FUCKING RESPONSE.
I will take another antibody test in 2 weeks or so. My fingers are crossed.
Now - B-cell and T-cell response - do I have that? Well, I don't know and there aren't any commercial tests for it. Fortunately I'm on the board of a rare disease foundation and have a lot of friends that are MD/PhD researchers at top institutions. In the coming weeks a friend and colleague of mine will be testing me for t-cell and b-cell responses in their own lab.
Other reasons for optimism - we know the response is dose-dependent. I can finagle my way into a third dose - no one will officially give me one, but I can just go sign up in a non-state-run site and get a third Pfizer at some point, by lying about my vaccination status. And eventually a fourth if I want. No institution will sanction that yet, because there are not yet studies that show it to be safe and effective, but my friends and even my transplant pulmonologist will support it off the record.
So the short answer is: for now this sucks, but I have a path forward.
Feel free to forward this to your buddy.
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Maybe you find this interesting? Maybe you've already seen it.
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Jon, it would be worth getting the additional shots. My completely unprofessional advice is that it shouldn't hurt you, and it might be the only way to build immunity. I wish you the best results as you go forward, and it's great you have excellent professional support for your options.
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Wow, that sucks. I'm sorry to hear that.
Would it make a difference if you'd increase the volume of a dose? Like, take three shots at once?
Well the response is dose dependent so something like that. The problem is no institution will do that today except as part of a registered clinical trial.
I’ll likely do it my own sneaky way at some point. Keep in mind there’s still hope for a B-cell and T-cell response.
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When you shake someone's deep sense of self-worth, leaving a scar in their ego, they will persistently try to diminish you through petty arguments & obsessive captious criticism of your actions, just to soothe the wound.
- Nassim Nicholas Taleb
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“I am fond of pigs. Dogs look up to us. Cats look down on us. Pigs treat us as equals.” ~Winston S. Churchill
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Jon, are you getting the same Pfizer shot, or have you considered mixing them up? I heard a discussion on the radio the other day that there's a theory that using different vaccines could increase their effectiveness. For obvious reasons, it's not something that was tested in development.
